Transient drop in the heart beat or transient heart block (AVB) may be consider the main cause of syncope or presyncope inpatients with bifascicular block and syncope According to the Guidelines for cardiac pacing pacemaker consider part of treatment. Aims of our study were to evaluate whether there is role for EPS in patients BFB and to evaluate the symptoms after pacing. 42 patients were enrolled in this study, with mean age value (63.4± 12.2years), suffer from interventricular conductive defect and syncope; patients underwent EPS on admission time, and pacemaker implantation accordingly and programmed follow up for the device in the last four years. Our patients were 25 (59.5%) male and 17 (40.5%)female, all of them with syncope or presncope and good left ventricular systolic function and the left ventricular ejection fraction (LVEF ≥55%). Left bundle branch block was found in 28 (66.71%) patients, while right bundle branch block were found in,14 (33.3) of them, the result of the EPS was find the cut of HV interval for pacing which represent that that the threshold at level of 75 have a sensitivity of 91% and specificity of 80%. The greater HV intervals gave more successful results for pacing. Pacemaker was implanted in 27 (64.3%) of the patients, with significant relation between pacing and syncope disappeared after pacemaker implantation (p value 000) and in 15 (35.7%) no pacemaker was implanted with persistent symptoms. Pacing were more between patients with coronary artery disease and LBBB with abnormal EPS finding. Permanent pacemaker implantation can implant directly in those old patients with syncope and bifascicular block that associated with LBBB and coronaries artery diseases without or before EP study
This research aims to shed light on the geography of Shatt Al-Gharraf, one of the main branches of the Tigris River south of the sedimentary plain, where the changes exposed by this Shatt (river) were followed by a set of old and modern maps, which date back to the years(3000 BC, 1771 AD, 1810 AD, 1944 AD, 1959 AD, 2009 AD, 2017 AD).Through this research, Shatt al-Gharrafwas found to be an integrated river in terms of the geomorphological phenomena of the rivers (river meanders, river islands, marshes, and estuary). Besides, it was exposed to several changes especially itsdownstream in the Euphrates. It was previously flowing into the Euphrates but due to a number of factors such as the shortage of water in the Tigris River in recent yea
... Show MoreThe paper has been summarized into the following:
Chapter one: the researcher deals with the problem of the paper, the most important points and the terminology. Chapter two: the researcher deals Surat Luqman from the Aya 12-19 , (the demonstration, the explanations, the values ). In chapter three the researcher deals with Surat AL-Hujurat from Aya 6-12, (the demonstration, the explanations, the values ). Chapter four include (the educational properties for individual and society, the educational applications, and the most important indicators in the texts). Chapter five include the results , the conclusions and the recommendations. One of the basic results that the Quran is a complete educational curriculum, and the texts of Surat Lu
Finding orthogonal matrices in different sizes is very complex and important because it can be used in different applications like image processing and communications (eg CDMA and OFDM). In this paper we introduce a new method to find orthogonal matrices by using tensor products between two or more orthogonal matrices of real and imaginary numbers with applying it in images and communication signals processing. The output matrices will be orthogonal matrices too and the processing by our new method is very easy compared to other classical methods those use basic proofs. The results are normal and acceptable in communication signals and images but it needs more research works.
Safety programmes are considered one of the means to protect workers from different accidents and injuries and also to protect all assets including machines equipment and various materials. In spite of world state interests in occupational safety, this subject didn't get the required attention by senior staff of management at most of our country construction factories and the application of safety programmes still limited and in active. In order to a achieve the goal of the study, scientific method has been pursued to obtain the necessary information related to this study through tours to related companies and their construction factories and review literature that deal with occupational safety subject and their programmes and cost, in a
... Show MoreThis research deals with Salinger's concerns about predicaments of youth like Franny and her brother Zooey. Their predicaments are related to identity, family, religion, beliefs, life and death, education, source of power, and society. It illustrates adults struggle to adapt themselves to live a normal social American life. It proves necessary to balance their coexistence in a materialistic milieu to achieve spiritual peace, tranquility, and stability.
Find goal to detect educational and technical staffing of style fiction in book reading school materials so determine the current research on the specific book reading in fourth grade of primary for the academic year 2014 issued by the Ministry of Education / Republic Iraq stories. Come in the importance of research to draw attention to the best of these stories and strengthened, and the negative deny it and claim his deportation in order to protect the thought of the learner, and the study may contribute to the development of some frameworks to write a story appropriate for elementary school. This McCann within the first chapter The second chapter included the theoretical framework has been contained on two main sections included the co
... Show MoreIn Nathaniel Hawthorn's The Scarlet Letter, love and hate appear as independent powers that consume their holders. In this novel, Nathaniel Hawthorn presents a picture of the Puritans which shows an important part of American history. The Scarlet Letter outlines the American's brief moment of theocracy and extreme social order. Hawthorn is one of the first American writers to explore the hidden motivations of his characters. The Puritans wanted to establish an ideal community in America that can act as a model of influence for what they saw as a corrupted civil and religious order in England. This sense of mission is the core of their religious and social identity. That is why they required a strict moral regulation. The research tackles th
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